NHS prescribed HRT - what are you on?

[Goatrider]

I thought it may be useful to have a thread for newbies like me, who are confused by HRT options mentioned on here.

To help us be prepared for when we attempt to get the elusive prescription from our GPs, if you are taking/have taken NHS prescribed HRT would you like to give a few details, such as -

Are you peri or post menopause?
What are you taking?
Is this tablet, gel or patch (or other?)
Did your GP give you options?
Benefits you have noticed
Side effects you have experienced, and did these clear up?
Ease of use

Any other comments?

Thanks

There ought to be no difference really between NHS and private options.

Private menopause specialists tend, on the whole, to know more about various options and can prescribe a bit more 'imaginatively '.

If you have a preference you can ask your GP for it.

Are you genuinely asking for yourself or composing some sort of guide for something else maybe?

I'm genuinely asking for myself and anyone else who wants to ask their gp for HRT and needs guidance. I don't have any ulterior motive. I just don't know anyone IRL that is on HRT to get info from.

I don't have a preference as I don't know what the options are, or pros and cons of each. I thought there were certain types that were only available privately.

Menopause Matters website has a list of all HRT under the HRT tab on the Home page.

Basically, older women (over 60) are advised to use patches or estrogen gel ( both are transdermal) to reduce risks of blood clots.

Younger women can use tablets or any of the above.

All HRT is available on the NHS.
I read here or somewhere that in Wales or Scotland there are some 'issues' about certain types not being available but don't know more.

Have a read around on the web about pros and cons of tablet form v patches etc. Some of it comes down to your own preferences.
Transdermal is safer and there is a move to try to get women away from pills.

OK thanks

I thought testosterone wasn't available on NHS?

Testosterone is not available for women per se, because there is no standard product for women, but can be prescribed by a consultant or sometimes a GP.

Hi OP
I take body identical HRT in the form of Oestrogen gel (daily) and progesterone tablets (for 12 out of 28 days). Please please check out Dr Louise Newson online. She is also known as The Menopause Doctor on IG.

I didn't find my prescription 'elusive' - what an odd choice of word. My GP was very happy to prescribe HRT and open to trying different options until we found the best one for me - her only caveat was that you had to give it 3 months to be sure it is working. Anyway, I am on Elleste Conti patches and they are a great help - I was physically fine, but the level of rage I was feeling was very unsettling. The HRT has taken the edge of it, I am still a grumpy cow at a regular times of the month - just not a psychotic grumpy cow.

Thank you for the replies.

Women I know haven't been able to get HRT from their GPs - which was I thought it seemed elusive. Some told they don't recommend it because of the risks or else they've just given them anti depressants.

I mentioned my symptoms to one of the GPs at my surgery and he just flatly told me that I couldn't be menopausal. I'm going back again, this time to see a female GP and I'm hoping for a more positive response.

My Dr hadnt heard of bio identicals and wouldn't refer me to the hospital that deals with them. So I had to go to the local nhs gaenachology consultant who hadn't heard of if either ! I gave up then and got the standard patches

I've been given my first
Prescription today. Early menopause. Turns
Out what I've been prescribed isn't available, manufacturing issue, so now I need to get a new appointment.

Some told they don't recommend it because of the risks or else they've just given them anti depressants.

Your GP cannot withhold it unless you have medical contraindications. The NICE meno guidelines say using HRT is a choice made by the woman in consultation with their dr. Any GP saying they do not prescribe due to risks is not working within guidelines and is also way behind the times regarding risks. You need to flag up this type of thing with the practice management.

I'm going back again, this time to see a female GP and I'm hoping for a more positive response

Gender ought to be irrelevant. There are stories here of of women finding women GPs unsympathetic.

My Dr hadnt heard of bio identicals and wouldn't refer me to the hospital that deals with them.

That's because they are not called bio-identicals.
They are, if anything, called body identical. Bio identical is a marketing term that came from the US. it is meaningless.

You need to ask for estradiol and micronised progesterone.
Body identical HRT is almost ALL estrogen used now except Premarin and Prempak.

My Dr hadnt heard of bio identicals and wouldn't refer me to the hospital that deals with them.

They are called body identical HRT. This is estradiol (in 99% of ordinary HRT) and micronised progestogen. Your patch will be body identical estradiol.

Bio identical was a US marketing term for compounded HRT which is not licensed in the UK.

Hi I'm 51 and peri-Memo. I have a morons coil so 3 weeks I started on Everol 25 patches, and it's helping my raging hot flushes and brain fog but it's reduced them by about 30% I'm back to see my GP in 3 weeks to be reassessed and probably go up to Everol 50 depending on how the next 3 weeks go.
I find that I seem to have more Energy and my joints don't ache as much as they had been and this is a great and unexpected bonus.
I've been suffering for 5 years with hot flushes and nigh sweats and it's just got so bad I gave in and asked for HRT sand now wonder why I was against taking it before

@lurkingattheback was that Everol 25 by any chance? It's hard to get hold of but they can get the 50mg apparently

Women I know haven't been able to get HRT from their GPs - which was I thought it seemed elusive. Some told they don't recommend it because of the risks or else they've just given them anti depressants.

Probably because anti-depressants may work better for mood related symptoms. HRT is not always the best option or necessary. Also depends on the age of the woman. It's very individual, there is not a one size fits all solution.

OP - please refer to www.menopausedoctor.co.uk/menopause/body-identical-hormones for correct information. You'll find a wealth of information here. If at all possible, go and see a private menopause specialist. The private specialist will prescribe a private prescription to start you off - with whichever version and variety of HRT they believe will suit you best. They will then write to your GP to have this prescription transferred to the NHS; you will get them via the NHS on a repeat basis thereafter. Please be cautious - there are some half facts on this thread I'm afraid. Go see a private meno specialist. If you are in Scotland, body identical HRT can absolutely be prescribed via the NHS.

Jingling - I was referring to women I know, not me. And not the same surgery as me.

Namaste - I would if I could afford it. I looked up the closest to me (which isn't that close) and it's £200 just for the initial Appointment

@PinkTomatoes
Probably because anti-depressants may work better for mood related symptoms. HRT is not always the best option or necessary

No they don't. That's incorrect. See NICE guide. ADs are not used for mood and depression resulting from hormonal changes.

Extract from NICE below.

Psychological symptoms
1.4.5 Consider HRT to alleviate low mood that arises as a result of the menopause.

1.4.6 Consider CBT to alleviate low mood or anxiety that arise as a result of the menopause.

1.4.7 Ensure that menopausal women and healthcare professionals involved in their care understand that there is no clear evidence for SSRIs or SNRIs to ease low mood in menopausal women who have not been diagnosed with depression (see the NICE guideline on depression in adults).

I was referring to women I know, not me. And not the same surgery as me.

But you were told you couldn't be menopausal.
What did you say your symptoms were and how did the dr arrive at that comment? How old are you now?
The most common symptoms are a change in periods, to more or fewer cycles, change in bleeding pattern/flow, hot flushes, insomnia, mood swings, weight gain etc.

As the PP says, if you can find £200 or so, you will get expert advice as long as you choose the dr carefully , and imo it's worth every penny if you have issues being 'heard' and treated correctly.

As a BTW, you may not need more than 1 appointment- perhaps a follow up one after a few months then the HRT may well be handled by your GP. £200 is not a lot of money for up to an hour's consultation with an expert when put into context of what people spend in a year on coffees, clothes, holidays etc. In my view. I know it's not possible for everyone.

I hadn't gone to GP for HRT. I was there about something else and mentioned I thought I could be Peri menopausal - I can't remember his reasoning for saying I couldn't be. I had already made a mental note not to see him again - I found he just didn't listen.

I'll see how I get on with my appointment at GP and will consider going private if things don't go well.

@JinglingHellsBells I agree completely. No one wants to spend in excess of £200 on a private app and it's a shame that we have to - if our GPs were consistently better informed, there would be no need. However it is what it is and I considered it, in the grand scheme to be money so very well spent. I was fortunate that my gp was well informed but he appreciated my need for a more specialised opinion and together they worked out the best solution for me. I know this is not possible for a lot of women which is awful.

@Namaste6
There was a recent survey done by Dr Louise Newsom where she asked a lot of GPs how confident they were about the menopause and HRT.
There were more who were not confident than who were! The results of her survey are on Twitter.

I know that GPs ought to offer support and be well informed but the specialists out there who end up seeing women who are being let down by GPs know the real world- and that's one where menopause is way down the list of interests and training for GPs. They get something like half a day of lectures at med school, so unless they read around it or go on a training course(s) that's why they know very little.

I agree completely that women ought not to have to go privately for health support. BUT we can't change the system overnight, it's going to take decades. IMO if you are comfortably off, or can find the money somehow, putting your health should come before clothes, holidays, new furniture, takeaways a few times a month, or whatever. Nothing matters more.

@JinglingHellsBells 👍

The lack of GP training and up to date information is Incredulous, especially considering at least half of their patients will be female.